| NPI | 1972967024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN ALEXANDER BAIN Owner 770-258-5516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN014278) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2016-04-05 |